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Simultaneous infection of the central nervous system with Cryptococcus neoformans and Mycobacterium intracellulare
Southern Medical Journal
|July 1, 1977
Abstract:
A 46-year-old woman with cryptococcal meningoencephalitis also had Mycobacterium intracellulare isolated from her cerebrospinal fluid. She was treated with amphotericin B,5-fluorocytosine, and antituberculous agents (isoniazid and rifampin). She gradually improved and was well, except for residual neurologic damage, three years after discharge from the hospital. No evidence of significant underlying disease has been found.
Insights
A rare coinfection of cryptococcal meningoencephalitis and Mycobacterium intracellulare in a 46-year-old woman was successfully treated. The patient showed gradual improvement with residual neurologic damage after combination therapy.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Cryptococcal meningoencephalitis is a serious fungal infection of the central nervous system.
- Coinfection with non-tuberculous mycobacteria presents diagnostic and therapeutic challenges.
Observation:
- A 46-year-old woman presented with cryptococcal meningoencephalitis.
- Mycobacterium intracellulare was concurrently isolated from her cerebrospinal fluid.
Findings:
- The patient received combination therapy including amphotericin B, 5-fluorocytosine, and antituberculous agents (isoniazid and rifampin).
- She experienced gradual clinical improvement over three years post-discharge.
- Residual neurologic damage was noted, but no significant underlying disease was identified.
Implications:
- This case highlights the importance of considering and managing polymicrobial central nervous system infections.
- Effective combination therapy can lead to favorable outcomes even in complex coinfections.
- Further research into optimal treatment strategies for such rare coinfections is warranted.